Hand Foot and Mouth Disease

Need to know: Hand foot and mouth disease

What causes it?

Hand foot and mouth disease (HFMD) is a common childhood illness that occurs as a result of infection with coxsackie group viruses. It usually affects children under the age of 10 but may sometimes affect adults.

How will it affect my child?

The infection produces a characteristic blistering rash, which predominantly affects the hands, including the palms of the hands, and the feet, including the soles. Blisters can also develop around the mouth and chin. Ulcers in the mouth may also occur, and these can make eating and drinking very painful. The blisters are 1 – 3mm in size, pale in colour and and filled with fluid. The blisters usually burst soon after they appear, and subsequently crust over, healing without leaving scars.

The severity of the rash can vary significantly – some children have only one or two tiny spots dotted around the hands and feet. In other cases the blisters can spread all over the hands and feet and up the arms and legs and around the bottom. Other symptoms can include a fever, and reluctance to eat or drink due to painful ulcers in the mouth.

What’s the treatment?

The infection takes about a week to clear and there isn’t a cure. The infection is usually mild and any pain or fever can be treated with paracetamol or ibuprofen. Encourage children to stay hydrated – if eating is sore then offer cold drinks and soft/cold foods, which require less chewing. You may wish to try oral gels or sprays, which can ease the pain of mouth ulcers. Your pharmacist can advise you on suitable treatments for you child.

Is it infectious and can I prevent it spreading?

Children with hand foot and mouth are mildly infectious for a few days before the rash appears but most likely to pass on the illness in the 5 days after developing spots. The infection can be spread through touching the infectious fluid from the blisters and though droplets which are spread by coughing and sneezing. The virus is also present in saliva and poo so wash hands carefully after changing nappies and avoid sharing cups and utensils.

If your child is feeling well it’s not usually necessary to keep them away from school or nursery but some nurseries and childcare facilities might have different policies. Most adults have been exposed and will have immunity to hand foot and mouth so it’s unusual for adults or children over 10 to get it. Hand foot and mouth doesn’t pose any serious risk to pregnant women or unborn babies but if you think you have hand foot and mouth during your pregnancy then let your midwife know; if you develop HFMD in the last few weeks of pregnancy then there’s a chance your newborn baby could develop the infection.

Dr Emma Scott (MBChB, MRCGP) is a qualified GP and mummy to two young children. She works in a GP practice in Edinburgh and in the out of hours GP service in Livingston and she has experience in both obstetrics & gynaecology and paediatrics.